OIB_04-02_Rosewood Investments LLC

Jan 27 04 05:02p
Torun Of Qcvan t a e 910 5'79 2940
P.)
OCean ISIC Beach
Local CovernmPnt
CAMA
MINOR DEVELOPMENT
aa—I L.11M(T
as authrwiaM by the Shoo a North C rafma, la"rhne it or [nva-ummCnt,
and Natural Etas""m anal the Coastal lis s aces Couunisslan for developmenL
In an,aree Of eloggarrment conCUM Wnsualt to Section 113A-119 aFfhe
General Statue; "Coastal Area Management"
04-02
Permit Number
Issued to Rosewowl-Ilavesttnents. LLC, authorizing develmpnlcht in C7eawn Haranl AFr at 278 Wiest
Hirer
Slevct Lot 11 kl er Resort as ieyt esled in the pemmnee•s applicationlte , dated la_ rin, 9 ?0(L4_ fhu
)surmit, na;.wJ on. •Jams • zuy1, is .object to compliance with the application and site drsov*(,whem
cnosistemt %•fill the permit), all applicable regulations and special condition mid holes set forts below. Any
vislia O of these tenma may subject peanlit.ce to a tine, intprisuntnent or civil action. or surly cause the ptYlilil to
Ile null and void
This parmil aoydvrizet the covtrrrumon 0(a mew single Jw.wily dwelling wish it l0's hi' cotwreJ deek:nr the, an jet vide.
am sk(rwn on Ike silk, rklon..
CONDITIONS FOR OCEAN NAXART) AE('S
(q toomalmnxm or Uevelopnknl in (k•e;m Narsol AW.. N.k nevOMpmrm shall hC011 until line octmflon seNaak
rcgUnement Can be eslabOsA.d. n4na1 the iN%1s'ySor of a Inertial or a losing of es ceplion is ready to lxein epnAnn'nup, Its
slurp "merge a nweliug ••ilh the vppmprialt pe nliuing plahu.it, or the .rift to determine she ucell"6111 w(lkw k. This •xthuck
dMGlninatimt shalt rephre the one done:d tile'time the rn- o ."t line"" Wait appruvyl and avnotranum mow I"ry.r+ill
in it period of o0-dav1 li out she dale of Thal meeting. in six Gue of a 1114iur ahUlelrne eha+yµ wnhtu slut piled afnen
kibock denhuinAtiuu will be lequired Idlore co IS11"lion lttalns. Upon completion of fix nxacmenxnt the In•.mlining
authority will vnia: a writimraalonvm lu the persnake •nil'yinit the sxrK.
(%) All prnp..vA dc.rlovmenr aoa ou.c,aer w•anus.i..n ..y.i. W d.ere in aa11ld1ae. r9111 she pCmollen work pink rlrat.ing•(.r)
dated icecived January 91-0(W
0) All coninlnason louts contemn to the N.C. Duitdiug Cowls hyuimarl's ;led all olive. l"Cel. State was i'"Imwl avers.% ..
;g.pheabtc hn:al Ordinwnaes Nld FF.MA Flood Regulations
(41 Any change err lwtgev it, tar Violist for aevoopnxlll• conplletUonet loner Ile activilips pill .eyui v a h:•evahclliuu :aRi
mn.b6c;klipn of This pemlil.
(1) The slntclme mus(be tented entirely ,It .d the holliol door, Jad if, postaldune is ptcssml• behind the crest of ale princwv
dune.
(b) Uwu: dislurb,•mee will be allowed 9* to the tltetn m.zisay Ile devel.anneai and if Ihr dole's prottvl,vc value is out
weakened of teduceo- Uislarbui areas - 11 sir imsook6 mh su Blued
(7) All 1wukb at'cas shall be vcgetmively planed and mulched within )0-days of construction coo pletom,
CONI)VIIONS COIN FUSUED ON NEXT PACE
ilea txwmn anion may be appeapss by the peon d1w or other
qu;Ji(i.d mgons..ahm tnm.ly JZUI days.a live ISavog nose. Fran _
0te Uc C. an appeal. any wag condoled under Its purrnl must L0c Pentil isWme) --
cease wtil the anpe8 u lesdved
This perwit must blk on [Ile prof ic! Wilt• and.1cs;t 501 to the permit Justi�l)p,Spe _
uhlCer AWN slo pretcel is nlsptelen ink, olmpganM CAMA I.=! Peinal Lftx;ll
Any mattlensism work or Islojact misdifigrotlor nul bvemd undH 1 m. �9
Iris perniL rethike(vntvn' %rippa en permit aovel. �.� �.�lAv. (lA�e�ool �nVC-�4u -(:s1
All work most shirr when this Want expires on DecvtlSer 11, I'erntlhee lakhlalde Itgalfe a t:at .JtK 6 We apply'0 Viet+%) .. �u
2007 __ ///{{{/t •1
in cawing Irvs porous it 6 agroto Inal Ilan p%Olttl 5 ptC.a:NN wid. ' I Q 1�
life local :and Use PPA and all applicable adnancds. s rn l mo
time flames ..ny not be. Imnstp.rcd to an ft, poly wKhoo tho Os1e pannllOc
wliaen approval of pw0ivtsion 0 Coastal Malnagome it,
=v DIVISION OF
COASTAL MANAGEMEN?

Name: Rosewood Investments
Minor Permit #: 04-02
Date: January 26, 2004
Page Two
(8) Any structure shall be relocated or dismantled when it becomes imminently threatened by changes in shoreline configuration.
The structure(s) shall be relocated or dismantled within two (2) years of the time when it becomes imminently threatened,
and if any case upon its collapse of subsidence. However, if natural shoreline recovery or beach nourishment takes place
with in 2 years of the time the structure becomes imminently threatened so that the structure is no longer imminently
threatened, then it need not be relocated or dismantled at that time. This condition shall not affect the permit holder's right to
seek authorization of temporary protective measures allowed and Rule .0308(a)(2) of the Ocean Hazard AEC Areas.
(9) Before the final inspection, the designing stormwater engineer must certify that the stormwater system was installed and
inspected as per the designing engineers specifications.
(10) Pursuant to 15 NCAC, Subchapter 71.0407(b), this permit may not be assigned, transferred, or otherwise disposed of to a
third party.
(11) If the driveway is located on the streetside of the residence, it must be gravel. NO IMPERVIOUS SURFACE MAY BE
PLACED IN THE 60' SETBACK FROM THE FIRST LINE OF STABLE NATURAL VEGETATION.
,SCSI
BAN 30 2004 1.�
pR� rhPN
Go

Locahr oC__ n (_ _ stirNtrmber L�-0A
,Jcean Hazard _ V:�EsruarJ=Shorefine _()RW Shoreine _pub4ic.' mn_Sboreline,Other__
(For official use only) E
�--E '�,_ i-i3VFORMATIC3N FIF
LAND OWNER g D
n 2004
Name_WeWDOd Inves+Mnts.L�i
�.idrrss Ile, affl�-(o Kobeson J'tre Qi- ruwN OF OCEAN IS
�p PLANNING R INcp
OM 1:+ty LOSae N �i Zip f O 3&5. — )'hone
AUTHORIZED AGENT
Na i Im JaeK5on
Address QNIJ-f Robeson Aruf
City FC<ue+le.ville, state k1b zip WD5 phoneQl0-484.7g8D
19CATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of
the adjacentwaterbody?) _Lff W. Ist Aaf+ ocean Isle 814M rJor+h Wollna_ 2840
i "II ISIGrld, Resarf
—R�PiiOAi OF -PROJECT.- (List all proposedconstruction and Land disturbance.)
nI r.An._... n. .-t_
SIZE-DFI-OT/PARCEL:
I q 3 9 8, 4 square feet Q. 40 _ acres
"IROPQ.SED-USE:Residential X-(Si{ei}y X}ri,fatn>f} _ j Commerical/Industrial
Other
TO -ENCLOSED FLOOR AREA O� �UILDING IN THE OCEAN HAZARD AREA OF ENVI-
RONMENTAL CONCERN (AEC): � _Sqoare feet+m—.lord sa{}{jnvrs and roof -covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS CDR BUILT-UWN SURFACES IN
'THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (.AEC): _ ' _ sq. g
(Calculations indude dac area of the roof/drip line of all buildings, xiveways, covcmd.cledu, concrete or masonry panos,
M that are widvn the applicable AEC. Attach your calttdarioms with the projtet drawing.)
'-Choose r%e AECarea that applies ce yen* property:
(1) within 75 feet of'Nonnal High Water for the Estuarine Shoreline AEC
`(7.)-'.+thin 574-feet of Normal High Watcr for the Estuarine Shoreline AEC, adjacent to Ourstan '(�5j qy 4
Resource W'atzec 111�.)d. JI11 \,V/
(3) -s Orin 3ti-ft:e t of the Public Trust: Shoreline AEC
(Contact your Local Permit Officer if you are not sure which AEC :Tplies to yourproperty) JAN 2 2004
STATE STORMWATER.MANAGEMENT PERMIT: Is the..prajealmcared-ioansrea subject to a DIVISION OF
.State Stormwater Management Permit issued by the N.C. Division of Water Qnaliry? COASTAL MANAGEMENT
YES_ NO.X _ .
If ycs, list the total built -upon area/impervious strrfaeealhnund for your lot orpircel.
square Fret.
C-d ObGZ GLS OIG alI ueaoo 40 umol dSb:CO 60 01 0a0

OTHER PERMITS MAY BE REQUIRED: The activityyou are planning may requirepermits other than the CAMA minor
�erelepnnenepermit.yls a service we have compiled a List of die kinds of permits dut a ighr be required W'rsuggen you check over the list
xuh your LPO m determine if any of these apply to your project. Zoning, Drinking Water Well, Septic Tank (or other sarurary waste
-%, x+ ncsmen*-Burning, Electrical, Munching,-ileatuhg and Air Conditioning, Insulation and Energy Conservation; RA Certification,
land Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Hghway, Connection; and others.
-STATEMENT OF OWNEISIP:
f:,frc-mr;dersignccd, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
)erson authorized ro act as an agent for purposes of applying for a CAMA minor develupsn=permit, certify that the permit
'isred aslandowner on this application has a significant interest in the real property described therein. This inrcresr can be
iesuibed as: (check one;
x an owner or rec d title.1-1de is vested in aqg w. ISt Stag Lot" l
,.age lL in dtr r nslu ` ____. need Book 1914
County Registry of Deeds.
_an owner by virtue of inheritance Applicant is an heir to the estate of
�robate+vasin
—if btherintemst, such as written contract or lease, explain below or use a seFarare sheet and attach tothis application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
:.furthermore-=ifyAar the followingpersarrs are -owners of properties adjoining this property. I affirm that I have given
\CTUAL NOTICE to each of them concerning my intent to develop this prope pry and to apply for a CAMA permit.
`fidarrtc) (Address)
;I) Leonell Benols+- 3342.311verPpnd L►�(harlpoe'WO, 2g2i1
;z) UotuarA �.Orebguah 15104 Georgia Avenue, 2oekville MD 10953
,3)
;4) FOR DEVELOPERS IN OCEAN HAZARD AND- STLTAjRIpEIIAZARD AREAS.
acknowledge that the lerhd owner is aware that the proposed development is
onion and/of flooding. I acknowledge that the local permit officer has ex larthy le to
tted with this lint. This explanation was accompanied by recomntendarions co1 h rd o e ecb- -
and Aoodpr r ech-
'f"EW1SS�N TO ENTER ON LAND: 9 2W4,E.rrrircrmore cerrify that I am authorized to grant and do in fact grant permi�ytlS�£,g�p(�}y� his a nts co
:ricer on the aforementioned lands in connection with evtluarinv fF usorenn"'viiod
5
z
I•his application includes: general information (this fntan),.asite.drawing as described-onZf e{ ack of this application, tie
>wnership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, n o
nation as may be provided orally by the a
Nirhout reference in any permit which may b��u & DThe eviaa on f orn tthesse details'
will coustdby these sources utute a violation of t perms. dyLd
rerson developing in an AEG withoutprinntat.is-9*ecr-to creti-Trimand admiaistrarive action.
This the day of-_ 20 BAN 12 2004
COAS q/)V 1 SION OF
Landowucr or person authorized to act as his agent for n",ose.of_fling a C -W permit application.MANAr: t= 4 sr-r,
b'd 046a GLS Ole all ueao0 40 utnol dsbrc0 c0 01 ciao

FRONT ELEVATION
1/4• . P•U"
JAN 12 2004
COAS Aft MANAGEMENT

REAR ELEVATION
V4" .
D 21z�,,3
JAN 12 2004
C AS gLMAIVAGEMENT

12._p"
12._0n
17-0..

n
V
K
8•-2.. 7'-10" 2'-0" 101_0•• 2•-0„
TRIPLE 2846
1 ;'•,24,;'I I
2846 2846
24" 40" 1;•D,Y ,I
o
CLO^l
KITCHEN
30•'
a
N
..---
jioi
BED ROOM 2
24' 30" 1 30••
14--0"
8•-D..
PMI WASHER
4'-6 1/2 4'-2 1/2
i M. BAR TOP
CORERY ELEV. 2068
0
�36.. REF DRYER
SHAFT SIZE BATH 2
I
n 30" X 60"
TUB/SHOWER
r
bb
ELEV
LLLL,�
�yt b 4
p m
DINING m
-ENTR 4'-l" 6•-4"
n
� n
u
c
9'-0"
as..
6'-8"
x 4'-4"
§
DN
O
BATH 1
=
b
i
o
N
. 6
tV
2•_4••
TYP I V 6
r
ism
Y.
iv
I 10-e" C.O. 8'-0" TALL
.- --
-
ro
b
m
b
F
n
N
N
p6
b
1O
0
x
3'-1D"
4'-0"
4'-2"
3'-8"
Lz
LIVING �I
BED ROOM 1
38••Ryl
92
3
2668
12'-0"
� o
0
OPEN
6'-4" LIMIT
1O
36" ROUND
g
UNIT
6'-0"
12•-0"
12•-0" 6-Q.
�''
I�
PROCH
JAN 12 20
MANA
EMEN
1r-o"
3B'-0•'
SECOND FLOOR
I

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
�laulard �. t7rehlzu�h
1510�} C'I�°r� is Av�?nu�
2cCKvi Ile, n1D 20853
A. Received by (Please Print Clearly) i B. Date of Delivery
C. Signature
❑ Agent
X ❑ Addressee
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3, ce Type
Certified Mail
❑ Express Mail
Registered
Retum Receipt for Merchandise
❑ Insured Mail
0 C.O.D.
4, Restricted Delivery? (Extra Fee) ❑ Yes
PS Form 3811-, July 1999 Domestic Return Receipt 102595-00-M-0952
BAN 12 2004
COgS DIL ISION OF
MANAGEMENT

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Le0MU betlo15t
334•1 Silver Pond & r�
arlb e,NL 201
9
PS Form 3811. July 1999
A Received by (Please Print Clearly) I B. Date of Delivery
C. Signature
❑ Agent
X ❑ Addressee
D. Is delivery address different from Item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ EcprsMail
Registered Return Receipt for Merchandise
❑ Insured Mail C.O.D.
4. Restricted Delivery? (Erna Fee) ❑ Yes
090'
Domestic Retum Receipt
102595-00-M-0952
-90.91VE
JAN 12 2004
D/VISIO
COASTAL M NAG6IMENT

L ft per A 1Ir4, o trd� toed Awa .. v owe the
� r t, d{oN er ed. +Mr NrY tta eddr..
!{wrLt 4r ?wtb! RP 4,•± #--wa4 r. prr ft d
[ n+o..wt1M w.t ad. r rr� o�w e/ r,r
i r t era
SEAL =
S47A
M
West 2nd Street 60'
A, r N MI'W E N 7�3:Ie2E _— i
Aebw pd
rd
of
$ s w
n =In
Lot 5 sit Lot 4 g�n Lot 3 gl.
SI
haw PUe rd
31
I r-I in S
n
N
lewd
sows R j{ le
n
N 7s15'51' E
/row P410e Jed
8.6. sot /
(w4Wo career)
5e.04'
4
•r
N 7rWit' E
Proposed o
0
House
8 W
g Location
Lot 12
!� ANar set 5 73'15'00" k r.ee rd ANor Jed E
LotWest 1st Street 60' R%WPl
SM2.0 SQ. FT. S..v a mot 49ms For.
0.13 ACUS
By Coordinates Rosewood Investments
Of Lot II. l t.nd.r A.eort At o.e.. 7de Ir"tddu4v
1 NOW
t. rer a Cmab+W we awd .oJer.wo. SAatiettr Teua.h:p DrwrrrbR Gey..ty, N.C.
GMtw ... Yap e{ Db. Page 171, of W
E =.vwak Govvwo AXWAIrs. p' 30` 60` 90'
s. Aewd ew Ooe� / /57 /teed
�rn..Qawe. Aale ra�mp $7ssb7 900s c
+-..w Arra 2, rsbf, OA4 pa.vet
to M M le"' vs. It tr, A rj, l{ /I'. some: i' - Su iwnamy :t, ZwJ i
y s. sew w * som"d from r.7.A.11. and 1
1 .aej.et to eearwp twawwMad.a. O Ma.s .... la,e s...n•. PA �a
y� S�,oy d Br. KS. BI F.I. / 031209A
NORRIS & WARD a.as._..w ween or. 3" Tee {Iasi
1 �[
Land c`%ryai CFS, P.-A. o-o Chseked By. $It, RW Poro.l
W000312-00 FB. 195, PO. 23
04-02
Hv
JAN I I IMI I I;
DIVISION OF
TAL MANAGE MEN17

{44ieeWs In An: V
r
Me I:vt WQQ Ph.11ted'
AEC HAZARD NOTICE
Afefl!o+"gitiiaaat'dfioodATea= Inlet Hazard Area
Tlisnoticu is intended to make you;-theapplimnt, aware
of the special risks and conditions associated with
development in this area, which is subject -to--natural
hazards such as storms, erosion and currents The rule; of
the Coastal Resources Commission require that you
rec�iVe an AEC Hazard IV •oti+e and acknnwlmp that
notice in " riting before a permit for development can be
wed.
Tita Cnm.m ssiow^ r,;l, ec achq...,li and c. n,_e>.,f.,.nt
2rnick: anddime al teradon arC't Stoned to mmimi?e,but
lint-lim_ngb -OrnrlelfV )nee =,,*n havar,d<, Rv oranitno
andnc
14,111111 forlu
ilir >_ie••�; :.-',; „�-,eat = _,
y turecfamage_to-thede,Plopme-nt.
The best available information, as accepted by the Coastal
-Resomoesfommission, indicates thattheannual ocean
erg 'on rate for the area where your property is located is
of -feet per year.
The rate was established by careful analysis of aerial
phetagreghs of the coasthrretaieerrwerthz pa t 50 years.
Studies a o indicate that the shoreline could move as
much as 2PQfeet landward in a major storm.
V6,IWTl flood waters in a major storm arepredictedtaheabout
feet deep in this area.
Pxe±cr-red-oceanfront protection --measures -are beach
nourishment and relocation of threatened structures.
Hard erosion control structures -.such as .bulkheads,
seawalls, revetments, groins, jetties and breakwaters are
prohibited. Temporary devices, including sand bags, may
be allowed under certain conditions.
This structure shall be relocated or dismantled within two
pearsof-bemming imminently threatened.
The applicant must acknowledge this information and
requirements by signing this notice in the below space.
Without the proper signature, the application will not be
cbrrrptete.
-Ap frcarrfs5i lure
Date
_SPECIALTTOTE: This hazard notice is required for
development in areas subject to sudden .and massive
storms and erosion. Permits issued for development in this
area expire on December 31 of the third year following the
vear in which -the permit was issued. Shortlybefore work
begins (in the project site, the Local Permit Officer will
-Aetermi iethevegetation lineand setback distmim at your
site If the property lias seen little change and the prope sed
develorm�ifsan..stil meet the setback requirex ent, k^
LPO will inform ynv'that you may beein wote
rk. It is impor-
tarit that you check wi th tfie L nO [.-_fore the permiterrv-=_s
for offic:al approval to continue the work after the permit
has excited. Generallv, if foundation pilines have been
d d > a -.a p-o;.e;> > oner t 5, p.
�'.�:; 'ai ' •.3Y ^Oi'J2 r?CaiSoTJ. 1 r SuhS:aAi: a: •1rOoC2c5 •_ ��
rwt-beeri..made the permit must be renewedr u da new
setback line established. It is unlawful to continue work
after permit expiration without this -approval.
For more information, contact:
Tl n WY1AS*(de
Local
-�Pel"l�rrnifOfficer 3 WtSi- N%rd
rx
Address
i
Locality
9/n' 5-79. 3 4G9
Phone
�FCV.
JAN ' F 20OU4
Revisud77193
L'ci 01,62 6LS 0T6 all Ue000 do umai d9b:co co oI oao

■ Complete items 1, 2, and I Also COmp1010 A. Reeelvod by (Faso r.vrt :+c�-yr I = r._.-
item 4 If Restricted Delivery is desired.
r Prier your name and address on the ieve," C. S
ddWS
so that we can return the card to you Anent
r ❑ Ad**U"
or on the front if space permits. i -t m t7—yea--
1. Article Addressed to:
Curjreek"M"
9QD1 S. bndj tdkVIOAU4
D. It ddlvoy ads n rom
d YES, enter delivery address debw: ❑ We
S. Sa Tv"
Mall
4 exp.�4 M011
g�Oo�rllged
glst"d
%Ree+d Rocelpt for Merchendlee
0 Insumd Mall
0 O.O.D.
4. FesmCled Dellvery7 (Extra Fee) ❑ Yes
2. A N Der IGOPY rmm serdce M1beP
_Ttg ApOPE10 oA 08%
PS Fclm 3611. July 1999 Domesfk Retum Receipt ta25m.ceM-uQS2

Pursuant to NCGS 113-119(b), the muni-
aality of *Ocean Isle Beach, a locality
ithorized to issue CAMA permits in the
eas of environmental concern, hereby
ves NOTICE that on January 9, 2604, ap-
icant Rosewood Investments, 11C, ap-
led for a CAMA minor development per -
it to construct a new single-family
velling at 278 W. First St., Lot 11, Islander
The application may be inspected at the
low address. Public comments received
January 23, 2604, will be considered. La-
r comments will be accepted and consid-
ed up to the time of permit decision. Pro-
t modifications may occur based on Pur-
er review and comments. Notice of the
rout decision in this matter will be pro-
ded upon written request.
Justin Whiteside
Local CAMA Permit Offlcer
3 West 3rd Street
Ocean Isle Beach, NC 28469
[phone]
Jan. 15
0` lJ
q�
Vk^ 0 2.
STATE OF NORTH CAROLINA
COUNTY OF BRUNSWICK
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State,
duly commissioned, qualified, and authorized by law to administer
oaths, personally appeared
Scott R. Harrell
who, being first duly swom, deposes and says: that he is
Publisher
(Owner, partner, publisher, or other officer or employee
authorized to make this affidavit)
of The Brunswick Beacon, a newspaper published, issued, and en-
tered as periodical mail in the Town of Shallotte in the said County
and State; that he is authorized to make this affidavit and sworn state-
ment; that the notice or other legal advertisement, a true copy of
which is attached hereto, was published in The Brunswick Beacon on
the following date(s):
January 15, 2004
and that the said newspaper in which such notice, paper document or
legal advertisement was published, was at the time of each and every
such publication, a newspaper meeting all the requirements and qual-
ifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597
of the General Statutes of North Carolina.
This the 15th day of January, 2004.
FE8 4 2CD4
C0,4 °rvisi�,, Z
(Signature of afff person making da` vit� L IV;; ; (\ OF
Sworn to and subscribed before me this 15th day of „�:��• GCA1Cf l
January, 2004.
A� LI
J•f/j6�
4d(Notary Public) �'•,, /C/�'01
My commission expires: December 29, 2004.